The Quality Assurance Process COG SWL | Nicholas Duffin About the - - PowerPoint PPT Presentation

The Quality Assurance Process

COG SWL | Nicholas Duffin

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The Quality Assurance Process

6 stages of evaluation for programmes of engagement and/or consultation

Before engagement or consultation starts

• 1. Scope/mandate and decision making
• 2. Project plan
• 3. Information and documentation

During engagement or consultation

• 4. Mid-review (in the middle few days)
• 5. Closing review (in the last week)

After the engagement or consultation finishes

• 6. Final report (reviewing the information for

decision making)

The Quality Assurance Process

5/4 stages of evaluation for option development and/or

• ption appraisal

Option development

• 1. The balanced room
• 2. Information - informing those involved
• 3. Process (Plan)
• 4. Information - contained within each solution
• 5. Report

Option appraisal

• 1. The balanced room
• 2. Information - informing those involved
• 3. Process (Plan)
• 4. Report

The Quality Assurance Process

What we are looking for:

• 1. Is it looking lawful
• 2. Does it look like good or best practice

Developing case for change Planning Investigation/research/analysis Sense checking Risk evaluation Impacts analysis Status quo mapping Impacts relevancy testing Issues or discussion paper Impact(s) assessment(s) Early involvement (SHs/SUs/IPs) Solutions based dialogue Values discussion Criteria establishing Intelligence gathering Threat profiling Risk testing Outputs evaluation & analysis Outputs evaluation & analysis Updated impact(s) assessment(s) Reports & updated case for change Options development Criteria confirmation Option appraisal Intelligence gathering Risk evaluation Consultation planning Information mediums development Impacts updating Option confirmation To consult or not? Updated impact(s) assessment(s) Consultation documents Consultation Options testing dialogue Impacts debate Impact claims testing Outputs evaluation and analysis Outputs evaluation and analysis Consultation reports and feedback Updated impact(s) assessment(s) Debate Reflection Decisions Publish decisions and rationale Updated impact(s) assessment(s)

Challenge point Challenge point

The model timeline

Early involvement (Imp profiles) Impacts exploration Impacts debate Conclusions testing

Engagement Consultation Engagement

Legislation Public & Common Law

Health Legislation Equality Legislation

Framework of the law

Local Gov Legislation

Legislation Public & Common Law

Gunning Principles

Framework of the law

Brown/Bracking Principles

Framework of the law - Health & Social Care Act 2012

S14Z2 Public involvement and consultation by clinical commissioning groups

• 2. The clinical commissioning group must make arrangements to secure that

individuals to whom the services are being or may be provided are involved (whether by being consulted or provided with information or in other ways)— a) in the planning of the commissioning arrangements by the group, b) in the development and consideration of proposals by the group for changes in the commissioning arrangements where the implementation

• f the proposals would have an impact on the manner in which the

services are delivered to the individuals or the range of health services available to them, and c) in decisions of the group affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact.

Framework of the law – NHS Act 2006

S242 (1B) Public involvement and consultation Each relevant English body must make arrangements, as respects health services for which it is responsible, which secure that users of those services, whether directly or through representatives, are involved (whether by being consulted or provided with information, or in other ways) in— a) the planning of the provision of those services, b) the development and consideration of proposals for changes in the way those services are provided, and c) decisions to be made by that body affecting the operation of those services.

Framework of the law - Heath and Social Care Act 2012

14T Duties as to reducing inequalities Each clinical commissioning group must, in the exercise of its functions, have regard to the need to— a) reduce inequalities between patients with respect to their ability to access health services, and b) reduce inequalities between patients with respect to the

• utcomes achieved for them by the provision of health services.

Plus other impact assessments if appropriate

Framework of the law - Equality Act 2010

S149 Public sector equality duty

• 1. A public authority must, in the exercise of its functions, have due regard to the need

to— a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under this Act; b) advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it; c) foster good relations between persons who share a relevant protected characteristic and persons who do not share it.

• 3. Having due regard to the need to advance equality of opportunity between persons

who share a relevant protected characteristic and persons who do not share it involves having due regard, in particular, to the need to— c) encourage persons who share a relevant protected characteristic to participate in public life or in any other activity in which participation by such persons is disproportionately low

Framework of the law - Local Authority Regs 2013 - HOSC

CCGs must: Notify of substantial developments or variations Consult the local authority S23(9) Subject to paragraph (10), the authority may report to the Secretary of State in writing where—

a) the authority is not satisfied that consultation on any proposal referred to in paragraph (1) has been adequate in relation to content or time allowed; b) in a case where paragraph (2) applies, the authority is not satisfied that the reasons (emergency changes) given by R are adequate; or c) the authority considers that the proposal would not be in the interests of the health service in its area.

S30 requirement to appoint joint scrutiny panels

R ex p Gunning v LB Brent 1985 - the Gunning Principles Gunning I: “a consultation must be at a time when proposals are still at a formative stage” Gunning II: “must give sufficient reasons for any proposal to permit of intelligent consideration” Gunning III: “adequate time must be given for consideration and response” Gunning IV: “the product of consultation must be conscientiously taken into account”

R (Bracking & others) v Secretary of State for Work and Pensions 2013 (Independent Living Fund)

• 1. Equality duties are an integral and important part of the mechanisms

for ensuing the fulfilment of the aims of anti-discrimination legislation.

• 2. An important evidential element in the discharge of the duty is the

recording of the steps taken by the decision maker in seeking to meet the statutory requirements.

• 3. The relevant duty is on the Minister or other decision maker personally.
• 4. A Minister (or decision maker) must assess the risk and extent of any

adverse impact and the ways in which such a risk may be eliminated before the adoption of a proposed policy. It is not a rearguard action following a concluded decision.

Equalty Act 2010 - PSED - Brown and Bracking Principles

Equality Act 2010 - PSED - Brown and Bracking Principles R (Bracking & others) v Secretary of State for Work and Pensions 2013 (Independent Living Fund)

• 5. The duty to have due regard to the relevant matters must be fulfilled before

and at the time when a particular policy is being considered and it is a continuing one. The duty must be exercised in substance, with rigour and with an open mind. It is not a tick box exercise.

• 6. It is not for the court to determine whether appropriate weight has been

given to the PSED.

• 7. The concept of due regard requires the court to ensure there has been a

proper and conscientious focus on the statutory criteria.

• 8. Public authorities must be properly informed before taking a decision. If the

relevant material is not available, there will be a duty to acquire it and this will frequently mean more consultation with appropriate groups is required.

How are they involving service users and others

Status quo analysis Solution exploration Solution development Option appraisal Consultation

• Baseline audit of existing service(s), including:
• How they meet the Equality and Health Inequality Duty - the gaps that need

improvement (and why) – engaging relevant profiles of people for views and evidence.

• Analyse of service user data held - for future engagement
• Stakeholder mapping - building a profile for engagement
• Engaging with staff, service users and interested parties to establish what works,

what doesn't, thoughts on what needs improvement (and why).

• Research on alternative models and successful transformation elsewhere
• Sense checking conclusions with relevant parties
• Risk evaluation - early identification of risks that might cause challenge

How are they involving service users and others

Status quo analysis Solution exploration Solution development Option appraisal Consultation

• Purpose: to gather information that is useful for solution development and
• ption appraisal.
• Focus: solutions based discussions, dialogues and exploration
• Peoples' ideas for total solutions
• What people think should be taken into consideration for solution design
• To ascertain what people consider will be or maybe the impacts of change,

their rationales for views and any evidence that supports what they say.

• Involvement of staff, service users, interested stakeholders, statutory

consultees, Equality characteristics, those that do or might suffer health inequality, independent experts, service providers.

• Qualitative and deliberative involvement with quantitative used to confirm

frequency of views, ideas, etc.

How are they involving service users and others

Status quo analysis Solution exploration Solution development Option appraisal Consultation

Purpose: to meet S14Z2 by involving service users and potential service users in working with clinicians, experts, etc, to ensure the services are designed to take account of their needs, knowledge of the services, unique local information, etc.

• Service users and potential service users
• Equality characteristics
• Those who suffering, could or will suffer health inequality
• Staff
• Stakeholders

How are they involving service users and others

Status quo analysis Solution exploration Solution development Option appraisal Consultation

Purpose: to meet S14Z2 by involving service users and potential service users in working with clinicians, experts, etc, to appraise the long list of solutions that have been developed, reducing them to a short list.

• Service users and potential service users
• Equality characteristics
• Those who suffering, could or will suffer health inequality
• Staff
• Stakeholders

How are they involving service users and others

Status quo analysis Solution exploration Solution development Option appraisal Consultation

Purpose: to test the options that remain by presenting people with sufficient information and opportunity to give meaningful responses to questions; questions designed to test each option and to find new information that may have been missed.

• Service users and potential service users
• Equality characteristics
• Those who are suffering, could or will suffer health inequality
• Staff
• Stakeholders
• The wider public

Are they asking the right questions?

S149 Public sector equality duty

• 1. A public authority must, in the exercise of its functions, have due regard to the need

to— a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under this Act; b) advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it; c) foster good relations between persons who share a relevant protected characteristic and persons who do not share it.

• 3. Having due regard to the need to advance equality of opportunity between persons

who share a relevant protected characteristic and persons who do not share it involves having due regard, in particular, to the need to— c) encourage persons who share a relevant protected characteristic to participate in public life or in any other activity in which participation by such persons is disproportionately low 1. Is there, could or will there be anything discriminatory? 2. Does anyone, could or will anyone suffer harassment? 3. Does anyone, could or will anyone suffer victimisation? 4. Disadvantage: does it exist now, could or will change create it? 5. Are we meeting peoples’ needs? Will we if we make changes? 6. Are we involving the seldom heard in our processes? 7. Is the status quo detrimental to good relations? How about changes? 8. Is there anything prejudicial now? What if we make changes? 9. Do we need to promote understanding between service users?

• 10. Does the status quo cater for different disabilities? What if we make changes?
• 11. Is there a need for favourable treatment for anyone?

Needs comparison between the status quo and your proposals. Needs conclusions of whether we will see an improvement or not in 1-11.

x 8 characteristics x number of

• ptions

Equality and Health Inequality by stage (1)

Status quo analysis Solution exploration Solution development Option appraisal Consultation

• Baseline audit of existing service(s), to ascertain how they meet the Equality and

Health Inequality Duty - the gaps that need improvement (and why) – engaging relevant profiles of people for views and evidence.

• Equality and Health Inequality stakeholder mapping - building a profile for

engagement

• Engaging with equality characteristics in staff, service users, representative

bodies and interested parties plus people that suffer health inequality (or could do) for their views on the status quo, and, to sense check any conclusions we have made from our research.

Equality and Health Inequality by stage (2)

Status quo analysis Solution exploration Solution development Option appraisal Consultation

• Purpose: to gather information that is useful for solution development and
• ption appraisal.
• Engaging with equality characteristics in staff, service users, representative

bodies and interested parties plus people that suffer health inequality (or could do) for their views on solutions and what should be considered in order that solutions do not have negative impacts but reduce where there are inequalities.

• To ascertain what people consider will be or maybe the impacts of change, their

rationales for views and any evidence that supports what they say.

• Qualitative and deliberative involvement with quantitative used to confirm

frequency of views, ideas, etc.

Equality and Health Inequality by stage (3)

Status quo analysis Solution exploration Solution development Option appraisal Consultation

Ensuring the involvement of equality characteristics and those who suffer, could or will suffer health inequality, in order that those taking the lead in developing solutions can be monitored and advised to take into account all peoples’ needs in design of solutions, based on what has been learned in the preceding phase and may emerge in design and development.

Equality and Health Inequality by stage (4)

Status quo analysis Solution exploration Solution development Option appraisal Consultation

Ensuring the involvement of equality characteristics and those who suffer, could or will suffer health inequality, in order that options are evaluated, considered and appraised taking account of the needs of all people that might use the service and those most vulnerable.

Equality and Health Inequality by stage (5)

Status quo analysis Solution exploration Solution development Option appraisal Consultation

Testing the options against the needs of people of the equality characteristics and those that do or may suffer health inequality now or if these proposals are implemented.

• Engaging with equality characteristics in staff, service users, representative

bodies and interested parties plus people that suffer health inequality (or could do) for their views on these solutions and what should be considered in order that solutions do not have negative impacts but reduce where there are inequalities.

• Qualitative involvement to debate the possible impacts plus quantitative

engagement to confirm frequency of views, ideas, etc.

That’s all folks!

Questions

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